Interferon beta(IFN-β) treatment exerts potential neuroprotective effects through neurotrophic factors and novel neurotensin/neurotensin high affinity receptor 1 pathway

Multiple sclerosis（MS）is a chronic autoimmune disease of the central nervous system（CNS）characterized by coexisting processes of inflammation,demyelination,axonal neurodegeneration,and gliosis.It is the most common disabling neurological disease in young adulthood.

Insulin exerts direct, IGF-1 independent actions in growth plate chondrocytes

Insufficient insulin production or action in diabetic states is associated with growth retardation and impaired bone healing, while the underling mechanisms are unknown. In this study, we sought to define the role of insulin signaling in the growth plate. Insulin treatment of embryonic metatarsal bones from wild-type mice increased chondrocyte proliferation. Mice lacking insulin receptor （IR） selectively in chondrocytes （CartIR-/-） had no discernable differences in total femoral length compared to control littermates. However, CartIR-/- mice exhibited an increase in chondrocyte numbers in the growth plate than that of the controls. Chondrocytes lacking IR had elevated insulin-like growth factor （IGF）-IR mRNA and protein levels. Subsequently, IGF-1 induced phosphorylafion of Akt and ERK was enhanced, while this action was eliminated when the cells were treated with IGF-1R inhibitor Picropodophyllin. Deletion of the IR impaired chondrogenic differentiation, and the effect could not be restored by treatment of insulin, but partially rescued by IGF-1 treatment. Intriguingly, the size of hypertrophic chondrocytes was smaller in CartIR-/- mice when compared with that of the control littermates, which was associated with upregnlation of tuberous sclerosis complex 2 （TSC2）. These results suggest that deletion of the IR in chondrocytes sensitizes IGF-1R signaling and action, IR and IGF-1R coordinate to regulate the proliferation, differentiation and hypertrophy of growth plate chondrocytes.

Serum procalcitonin levels are associated with rhabdomyolysis following exertional heatstroke: an over 10-year intensive care survey

BACKGROUND:Heatstroke has become a common emergency event in hospitals.Procalcitonin(PCT)is used as a biomarker of infection in the emergency department(ED),but its role in rhabdomyolysis(RM)following exertional heatstroke(EHS)remains unclear.METHODS:A retrospective cohort study enrolled patients with EHS from the intensive care unit(ICU).We collected RM biomarkers,inflammation markers,critical disease scores at admission,24 h,48 h,and discharge,and 90-day mortality.Correlation analysis,linear regression and curve fi tting were used to identify the relationship between PCT and RM.RESULTS:A total of 162 patients were recruited and divided into RM(n=56)and non-RM(n=106)groups.PCT was positively correlated with myoglobin(Mb),acute hepatic injury,disseminated intravascular coagulation(DIC),Sequential Organ Failure Assessment(SOFA)score,and Acute Physiology and Chronic Health Evaluation II(APACHE II)score,with correlation coefficients of 0.214,0.237,0.285,0.454,and 0.368,respectively(all P<0.05).Interestingly,the results of curve fi tting revealed a nonlinear relationship between PCT and RM,and a two-piecewise linear regression model showed that PCT was related to RM with an odds ratio of 1.3 and a cut-off of<4.6 ng/mL.Survival analysis revealed that RM was associated with higher mortality compared to non-RM cases(P=0.0093).CONCLUSION:High serum PCT concentrations are associated with RM after EHS in critically ill patients.Elevated PCT concentrations should be interpreted cautiously in patients with EHS in the ED.

Clinical Study of Shentong Zhuyu Decoction Combined with Massage Therapy in the Treatment of Exertional Chronic Lumbar Muscle Strain

[Objectives]To explore the effects of Shentong Zhuyu decoction combined with massage therapy in the treatment of exertional chronic lumbar muscle strain.[Methods]Sixty-four cases of exertional chronic lumbar muscle strain were randomly divided into two groups(32 cases each group).The patients in the control group only took celecoxib capsules,and those in the treatment group additionally took Shentong Zhuyu decoction combined with massage therapy.TCM syndrome score,lumbar function,hemorrheology index and clinical effect were compared between the two groups before and after treatment.[Results]After treatment,the TCM syndrome scores of lumbar distension/dull pain,tingling-like lumbago,adverse lateral turn,body weight loss,dark purple tongue,slow or astringent pulse,and Oswestry disability index(ODI)score in the treatment group were lower than those in the control group,and the levels of plasma viscosity,red blood cell aggregation index,platelet aggregation rate(PAG)and fibrinogen(Fib)were lower than those in the control group,showing statistical significance(P<0.05).The overall clinical effect distribution of the treatment group was better than that of the control group,and the difference was statistically significant(P<0.05).[Conclusions]Shentong Zhuyu decoction combined with massage therapy can effectively relieve the symptoms of patients with lumbago and improve the lumbar mobility function and hemorrheology,with obvious therapeutic effects in the treatment of exertional chronic lumbar muscle strain.

Calculatons of the Electron Radius

Equating the Rest Mass Energy of a free electron to its Rest Charge Energy we prove that the electron cannot be a dimensionless point particle because if it were dimensionless, it would contain an infinite amount of Rest Charge Energy at the location of its charge since r = 0 gives , which is clearly not possible. Since the electron has no internal structure, equating its Rest Mass Energy to its Rest Charge Energy, we calculate the electron to be a sphere of radius 4.68 × 10-16 meters. We calculate the Electric Field at the surface of the electron due to its charge and the Repulsive Force two electrons in proximity exert on each other.

Exertional Rhabdomyolysis Induced Acute Kidney Injury: A Case Report and Literature Review

Background: The exRML (exertional rhabdomyolysis) is a pathophysiologic condition of skeletal muscle cell damage and breakdown associated with high intensity or prolonged exercise, normal exercise under extreme circumstances, or sudden and excessive skeletal muscle contraction. It may manifest from the increase in CK (creatine kinase) or MYO (myoglobin), a protein that can cause life-threatening injury to the kidney (AKI, acute kidney injury), and may or may not be associated with myoglobinuria. Here, we presented a case of exRML with AKI, and then reviewed the related reports. Vigorous hydration, sodium bicarbonate and furosemide are key treatments. Aim: To examine an elderly patient with exRML induced AKI and the key treatment process. Case summary: A 61-year-old man left our hospital without permission after his admission and has been walking for almost 30 kms with no water and food intake, then was diagnosed exRML and exRML induced AKI with an obvious elevation of CK, MYO and decrease of eGFR (estimated glomerular filtration rate) after coming back, and was treated with vigorous hydration, loop diuresis, sodium bicarbonate, prostaglandin and Shenkang injection. After vigorous resuscitation, the patient’s renal function, CK and MYO returned normal. Conclusions: The exRML can cause serious complications such as AKI and death. Delayed diagnosis can be critical;therefore, manner of time should be taken to achieve a favorable prognosis.

A nomogram based on lymphocyte percentage for predicting hospital mortality in exertional heatstroke patients: a 13-year retrospective study

BACKGROUND: Exertional heatstroke(EHS) is a life-threatening disease without ideal prognostic markers for predicting hospital mortality.METHODS: This is a single-center retrospective study. Clinical data from EHS patients admitted to the Intensive Care Unit(ICU) of the General Hospital of Southern Theatre Command between January 1, 2008, and December 31, 2020, were recorded and analyzed. Univariate and multivariate logistic regression were used to identify the factors for mortality. The prediction model was developed with the prognostic markers, and a nomogram was established.RESULTS: The study ultimately enrolled 156 patients, and 15(9.6%) of patients died before discharge. The lymphocyte count(Lym) and percentage(Lym%) were significantly lower in nonsurvivors(P<0.05). The univariate and multivariate logistic regression analyses indicated that Lym% at the third day of admission(Lym% D3)(OR=0.609, 95%CI: 0.454–0.816) and hematocrit(HCT)(OR=0.908, 95%CI: 0.834–0.988) were independent protective factors for hospital mortality. A nomogram incorporating Lym% D3 with HCT was developed and demonstrated good discrimination and calibration ability. The comparison between the prediction model and scoring systems revealed that the prediction model had the largest area under the curve(AUC)(0.948, 95%CI: 0.900–0.977), with 100.00% sensitivity and 83.69% specificity, and a greater clinical net benefit.CONCLUSION: Severe EHS patients had a higher risk of experiencing prolonged lymphopenia. A nomogram based on Lym% D3 and HCT was developed to facilitate early identification and timely treatment of patients with potentially unfavorable prognoses.

Exercise Intolerance and Excessive Chronotropic Response Due to Possible Autonomic Dysfunction Post COVID-19 Infection

Introduction and Objectives: In patients with Post-Acute Sequelae of Coronavirus 2 infection (PASC), a post infectious autonomic dysfunction may be one of the underlying mechanisms. Patients often present with exercise intolerance and exaggerated heart rate response to exercise. We report a single centre experience of patients with PACS and suspected autonomic dysfunction. Methods: Forty-two patients evaluated in the Outpatient Cardiology Department with suspected PASC were included in the study. Patients complained of compromised exercise performance persisting >3 months after recovery from COVID-19 infection, compared to the pre-COVID-19 period. The patients were evaluated with 12-lead electrocardiogram, echocardiography, 24-hour ECG ambulatory monitoring and either exercise stress test or a 6-minute walk test. Results: All 42 patients demonstrated an exaggerated chronotropic response, defined as the inappropriate increase in heart rate before the 6th minute of exercise >100% of the age-predicted maximal heart rate value with reproduction of clinical symptoms. In addition, 24-hour ambulatory electrocardiography revealed an increased mean heart rate of 92 beats/minute and decreased mean standard deviation of sequential 5-minute N-N interval (SDNN) of 74.4 ms. Pharmaceutical treatment with b-blockers, ivabradine or both was administrated in 29 (69%) resulting in symptomatic improvement in 82.8% of those under treatment. However, residual symptoms persisted in 69% of patients after 3 months. Conclusions: In patients with “Post-acute COVID-19” syndrome, we found an excessive chronotropic response to exercise suggesting autonomic dysfunction as the underlying mechanism of symptoms. Treatment with beta blockers or ivabradine resulted in clinical improvement but a substantial proportion of patients remained symptomatic.

浅评《韦氏大学词典》第十版

《韦氏大学词典》是美国最大的词典《韦氏新国际词典》的简编,是美国最主要的一种大学型词典,初版于1898年,最新版是1994年第十版(以下简称《十版》)。英文名字是:Merrian Webster’s CollegiateDictionary,Tenth Edition。由于足本的《韦氏新国际词典》在1961年出了第三版后,(以下简称《国际三版》)

Expert consensus on the diagnosis and treatment of heat stroke in China

Heat stroke(HS)is a fatal disease caused by thermal damage in the body,and it has a very high mortality rate.In 2015,the People’s Liberation Army Professional Committee of Critical Care Medicine published the first expert consensus on HS in China,Expert consensus on standardized diagnosis and treatment for heat stroke.With an increased understanding of HS and new issues that emerged during the HS treatment in China in recent years,the 2015 consensus no longer meet the requirements for HS prevention and treatment.It is necessary to update the consensus to include the latest research evidence and establish a new consensus that has broader coverage,is more practical and is more in line with China’s national conditions.This new expert consensus includes new concept of HS,recommendations for laboratory tests and auxiliary examinations,new understanding of diagnosis and differential diagnosis,On-site emergency treatment and In-hospital treatment,translocation of HS patients and prevention of HS.

Cardiac adipose tissue and its relationship to diabetes mellitus and cardiovascular disease

Type-2 diabetes mellitus(T2DM) plays a central role in the development of cardiovascular disease(CVD). However, its relationship to epicardial adipose tissue(EAT) and pericardial adipose tissue(PAT) in particular is important in the pathophysiology of coronary artery disease. Owing to its close proximity to the heart and coronary vasculature, EAT exerts a direct metabolic impact by secreting proinflammatory adipokines and free fatty acids, which promote CVD locally. In this review, we have discussed the relationship between T2 DM and cardiac fat deposits, particularly EAT and PAT, which together exert a big impact on the cardiovascular health.

EFFECT OF ACUPUNCTURE AND POINT-INJECTION TREATMENT ON IMMUNOLOGIC FUNCTION IN RHEUMATOID ARTHRITIS

The results of treatment of 54 cases of rheumatoid arthritis(RA)by warm needling(WN)and point-injection(PI)with Zhuifengsu are reported.Good clinical results were observedwith an effective rate of 100%.At the same time,changes in cellular and humoral immunityand other parameters in peripheral blood were noted before and after treatment.The NK ac-tivity and IL-2 value in RA patients were found to be lower than those of normalindividuals;both increased after treatment(P【0.01).This suggests that the WN and PIwith Zhuifengsu exert a regulatory effect on the cellular immunological function.

EFFECTS OF NALOXONE ON THE CHANGES OF PAIN THRESHOLD AND CONTENTS OF MONOAMINE NEUROTRANSMITTERS IN RAT BRAIN INDUCED BY EA

5-HT content in medulla oblongata plus pons and DA level in brain stem obviously increased,while NA concentration in telencephalon markedly decreased in EAA.A previous injection ofnaloxone,a blocker of opiate receptor,could partially inhibit the EAA,abolish the effects ofEA’s increasing the 5-HT content in the medulla oblongata plus pons and the DA level in thebrain stem,and decrease the NA level in the diencephalon after EA.These results indicate thatEA may mediate the metabolism of the central monoamine neurotransmitters partially via opiatereceptor to exert its analgesic effect.

PRESENT STATUS OF RESEARCH ABROAD CONCERNING THE EFFECT OF ACUPUNCTURE AND MOXIBUSTION ON IMMUNOLOGIC FUNCTIONS

Much research has been conductedabroad in recent years concerningacupuncture and moxibustion on theimmunologic functions of the organism.Anoutline of this is presented as follows.EFFECTS OF ACUPUNCTUREAND MOXIBUSTION ON NORMALIMMUNOLOGIC FUNCTIONS

Establishment and effectiveness evaluation of a scoring system for exertional heat stroke by retrospective analysis

Background: Heat stroke(HS) is a serious, life-threatening disease. However, there is no scoring system for HS so far. This research is to establish a scoring system that can quantitatively assess the severity of exertional heat stroke(EHS).Methods: Data were collected from a total of 170 exertional heat stroke(EHS) patients between 2005 and 2016 from 52 hospitals in China. Univariate statistical methods and comparison of the area under the receiver operating characteristic(ROC) curve(AUC) were used to screen exertional heat stroke score(EHSS) parameters, including but not limited body temperature(T), Glasgow Coma Scale(GCS) and others. By comparing the sizes of the AUCs of the APACHE II, SOFA and EHSS assessments, the effectiveness of EHSS in evaluating the prognosis of EHS patients was verified.Results: Through screening with a series of methods, as described above, the present study determined 12 parameters – body temperature(T), GCS, p H, lactate(Lac), platelet count(PLT), prothrombin time(PT), fibrinogen(Fib), troponin I(Tn I), aspartate aminotransferase(AST), total bilirubin(TBIL), creatinine(Cr) and acute gastrointestinal injury(AGI) classification – as EHSS parameters. It is a 0–47 point system designed to reflect increasing severity of heat stroke. Low(EHSS<20) and high scores(EHSS>35) showed 100% survival and 100% mortality, respectively. We found that AUCEHSS>AUCSOFA>AUCAPACHE II.Conclusions: A total of 12 parameters – T, GCS, p H, Lac, PLT, PT, Fib, Tn I, AST, TBIL, Cr and gastrointestinal AGI classification – are the EHSS parameters with the best effectiveness in evaluating the prognosis of EHS patients. As EHSS score increases, the mortality rate of EHS patients gradually increases.

Effects of music and video on perceived exertion during high-intensity exercise

Background: Dissociative attentional stimuli(e.g., music, video) are effective in decreasing ratings of perceived exertion(RPE) during low-tomoderate intensity exercise, but have inconsistent results during exercise at higher intensity. The purpose of this study was to assess attentional focus and RPE during high-intensity exercise as a function of being exposed to music, video, both(music and video), or a no-treatment control condition.Methods: During the first session, healthy men(n = 15) completed a maximal fitness test to determine the workload necessary for high-intensity exercise(operationalized as 125% ventilatory threshold) to be performed during subsequent sessions. On 4 subsequent days, they completed 20 min of high-intensity exercise in a no-treatment control condition or while listening to music, watching a video, or both. Attentional focus, RPE,heart rate, and distance covered were measured every 4 min during the exercise.Results: Music and video in combination resulted in significantly lower RPE across time(partial η~2= 0.36) and the size of the effect increased over time(partial η~2= 0.14). Additionally, music and video in combination resulted in a significantly more dissociative focus than the other conditions(partial η~2= 0.29).Conclusion: Music and video in combination may result in lower perceived exertion during high-intensity exercise when compared to music or video in isolation. Future research will be necessary to test if reductions in perceived exertion in response to dissociative attentional stimuli have implications for exercise adherence.

Exertional rhabdomyolysis and heat stroke: Beware of volatile anesthetic sedation

In view of the enormous popularity of mass sporting events such as half-marathons, the number of patients with exertional rhabdomyolysis or exercise-induced heat stroke admitted to intensive care units(ICUs) has increased over the last decade. Because these patients have been reported to be at risk for malignant hyperthermia during general anesthesia, the intensive care community should bear in mind that the same risk of life-threatening rhabdomyolysis is present when these patients are admitted to an ICU, and volatile anesthetic sedation is chosen as the sedative technique. As illustrated by the three case studies we elaborate upon, a thorough diagnostic work-up is needed to clarify the subsequent risk of strenuous exercise, and the anesthetic exposure to volatile agents in these patients and their families. Other contraindications for the use of volatile intensive care sedation consist of known malignant hyperthermia susceptibility, congenital myopathies, Duchenne muscular dystrophy, and intracranial hypertension.

MicroRNA-26a inhibits osteosarcoma cell proliferation by targeting IGF-1

There are still controversies about the roles of microRNA-26a（miR-26a）in human malignancies,as it is a tumor suppressor in breast cancer,gastric cancer,and hepatocellular carcinoma,but is an oncogene in glioma and cholangiocarcinoma.Until now,the function of miR-26a in osteosarcoma remains largely elusive.Here,we found that miR-26a was downregualted in osteosarcoma tissues.Using in vitro and in vivo assays,we confirmed that miR-26a could inhibit the abilities of in vitro proliferation and suppress in vivo tumor growth in mouse model.Furthermore,we identified insulin-like growth factor 1（IGF-1）as a novel and direct target of miR-26a and revealed that miR-26a exerted its tumor-suppressor function,at least in part,by inhibiting IGF-1expression.These findings contribute to our understanding of the functions of miR-26a in osteosarcoma.

Curcuminoids Target Decreasing Serum Adipocyte-fatty Acid Binding Protein Levels in Their Glucose-lowering Effect in Patients with Type 2 Diabetes

Whether supplementation of curcuminoids decreases serum adipocyte-fatty acid binding protein（A-FABP） level and whether this decrease benefits glucose control is unclear.One-hundred participants（n=50 administered curcuminoids,n=50 administered placebo） from our previous report on the effect of curcuminoids on type 2 diabetes in a 3-month intervention were assessed for levels of serum A-FABP,oxidative stress,and inflammatory biomarkers.Curcuminoids supplementation led to significant decreases in serum A-FABP,C-reactive protein（CRP）,tumor necrosis factor-α,and interleukin-6 levels.Curcuminoids supplementation also significantly increased serum superoxide dismutase（SOD） activity.The change in serum A-FABP levels showed positive correlations with changes in levels of glucose,free fatty acids（FFAs）,and CRP in subjects supplemented with curcuminoids.Further stepwise regression analysis showed that A-FABP was an independent predictor for levels of FFAs,SOD,and CRP.These results suggest that curcuminoids may exert anti-diabetic effects,at least in part,by reductions in serum A-FABP level.A-FABP reduction is associated with improved metabolic parameters in human type 2 diabetes.

Effects of compression garments on surface EMG and physiological responses during and after distance running

Background:The few previous studies that focused on the effects of compression garments(CG)on distance running performance have simultaneously measured electromyogram,physiological,and perceptual parameters.Therefore,this study investigated the effects of CG on muscle activation and median frequency during and after distance running,as well as blood-lactate concentration and rating of perceived exertion(RPE)during distance running.Methods:Eight healthy male recreational runners were recruited to randomly perform two 40 min treadmill running trials,one with CG,and the other with control garment made of normal cloth.The RPE and the surface electromyography(EMG)of 5 lower extremity muscles including gluteus maximus(GM),rectus femoris(RF),semitendinosus(ST),tibialis anterior(TA),and gastrocnemius(GAS)were measured during the running trial.The blood-lactate levels before and after the running trial were measured.Results:Wearing CG led to significant lower muscle activation(p<0.05)in the GM(decreased 7.40%-14.31%),RF(decreased 4.39%-4.76%),and ST(decreased 3.42%-7.20%)muscles;moreover,significant higher median frequency(p<0.05)in the GM(increased 5.57%)and ST(increased 10.58%)muscles.Wearing CG did not alter the RPE values or the blood-lactate levels(p>0.05).Conclusion:Wearing CG was associated with significantly lower muscle activation and higher median frequency in the running-related key muscles during distance running.This finding suggested that wearing CG may improve muscle function,which might enhance running performance and prevent muscle fatigue.